van Dijk Elon H C, Dijkman Greet, Boon Camiel J F
Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Graefes Arch Clin Exp Ophthalmol. 2017 Oct;255(10):2029-2035. doi: 10.1007/s00417-017-3720-z. Epub 2017 Jul 3.
To assess the efficacy of photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC), in whom subretinal fluid (SRF) was solely present outside the foveal area.
In this retrospective study, 16 eyes of 15 cCSC patients who received half-dose PDT because of notable subjective visual complaints due to the presence of extrafoveal SRF, were included. An ophthalmic examination was performed before treatment, including Early Treatment Diabetic Retinopathy Study best-corrected visual acuity measurement, applanation tonometry, slit-lamp examination, and indirect ophthalmoscopy, followed by multimodal imaging, including fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (OCT), enhanced-depth imaging OCT of the choroid, fluorescein angiography, and indocyanine green angiography.
In 7 treated patients (47%), PDT led to a decrease in visual complaints at the first evaluation visit. At this visit, extrafoveal SRF on OCT had resolved in 14 eyes (88%), whereas a complete resolution of extrafoveal SRF had occurred in all eyes at final follow-up visit. At baseline, posterior cystoid retinal degeneration was also present in 5 eyes (31%) and this remained present at all evaluation visits in these patients. Choroidal thickness decreased statistically significantly in the treated eyes, both foveally and at the location of the maximum height of extrafoveal SRF. No complications of PDT were observed.
Half-dose PDT treatment of cCSC patients with visual complaints due to extrafoveal SRF accumulation is a safe procedure leading to complete SRF resolution, a decrease in choroidal thickness, and a reduction in visual symptoms.
评估光动力疗法（PDT）对慢性中心性浆液性脉络膜视网膜病变（cCSC）患者的疗效，这些患者的视网膜下液（SRF）仅存在于黄斑区以外。
在这项回顾性研究中，纳入了15例cCSC患者的16只眼，这些患者因黄斑外SRF的存在而出现明显的主观视觉症状，接受了半剂量PDT治疗。治疗前进行了眼科检查，包括早期糖尿病视网膜病变研究最佳矫正视力测量、压平眼压测量、裂隙灯检查和间接检眼镜检查，随后进行了多模态成像，包括眼底摄影、眼底自发荧光、光谱域光学相干断层扫描（OCT）、脉络膜增强深度成像OCT、荧光素血管造影和吲哚菁绿血管造影。
在7例接受治疗的患者（47%）中，PDT在首次评估时导致视觉症状减轻。在此次评估时，OCT上黄斑外SRF在14只眼中（88%）已经消退，而在最后一次随访时所有眼中黄斑外SRF均已完全消退。基线时，5只眼（31%）也存在后极部囊样视网膜变性，并且在这些患者的所有评估中均持续存在。治疗眼的脉络膜厚度在黄斑区以及黄斑外SRF最高处均有统计学意义的显著下降。未观察到PDT的并发症。
对因黄斑外SRF积聚而出现视觉症状的cCSC患者进行半剂量PDT治疗是一种安全的方法，可导致SRF完全消退、脉络膜厚度降低以及视觉症状减轻。
